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Biomedical subjects

W C McCormick

Publications and source records attributed to W C McCormick.

At least 73 records · Page 4Linked to original sources
PubMed1984

Grading and rotational crossbreeding of beef cattle. II. Calf performance to weaning.

Purebred Angus (A), Polled Hereford (PH) and Santa Gertrudis (SG) bulls were mated to grades, two-breed and three-breed rotational crosses of these breeds (seven herds) to produce three generations (G1, G2, G3) of calves. Birth weight and weaning traits were evaluated for herd differences, heterosis and effects of various genetic components. For each generation, the mean birth weight of SG exceeded that of PH which exceeded A (P less than .05). Averaged over generations, A and PH performed similarly for daily gain, 205-d weight and 205-d weight/cow exposed while SG exceeded A and PH for these traits. For feeder score, the breeds ranked A, PH, SG. For birth weight, daily gain, 205-d weight and 205-d weight/cow exposed, breeds ranked SG, PH, A for average additive genetic effects on the traits. Heterozygotic effects due to breed crosses, averaged over the three generations, were positive for all traits and generally significant, with PH X SG displaying more heterosis than the other two crosses. The maternal effects for A and SG were greater than PH for all traits except birth weight. Of the traits studied, from 12 (205-d wt/cow exposed) to 52% (205-d wt) of the variation averaged over generations was accounted for by a partial regression model that determined breed additive, breed maternal, heterosis and average maternal heterosis effects. Also averaged over generations, from .3 (205-d wt/cow exposed) to 1.7% (avg daily gain) additional variation was due to factors that may have included specific maternal heterosis, epistasis and linkage.

Animals↗
PubMed1984

Therapeutic substitution: has its time arrived?

Therapeutic substitution refers to substitution by the dispenser of a drug product that is not chemically identical but is therapeutically equivalent to the product prescribed, pursuant to guidelines established by the hospital P & T Committee. Until recently, the extent to which this concept has been adopted by hospitals across the country was unknown. Late in 1980, we conducted a nationwide survey of hospital pharmacies to learn more about therapeutic substitution. This paper reviews some of the issues involved, some of the findings of our study, and the pros and cons of therapeutic interchange. It also provides an update as to some of the recent changes that are occurring in therapeutic substitution procedures.

Data Collection↗
PubMed1984

Education and experience of pharmacy directors in large hospitals.

The education and experience of pharmacy directors in large hospitals are described. Questionnaires were sent in September 1981 to pharmacy directors of all hospitals in the United States having at least 300 beds. The questionnaire elicited background characteristics, postgraduate degrees, and administrative experience of the pharmacy director and descriptive information about the hospital. Of the 1483 questionnaires distributed, 609 (41%) were returned. Sixty percent of the respondents had an entry-level degree as their highest degree; 26%, 6%, and 7% of the respondents had M.S., M.B.A., and postgraduate Pharm .D. degrees, respectively. M.B.A. and postgraduate Pharm .D. degrees were more common for younger respondents. Only 6% of directors with entry-level degrees and 10% with M.B.A. degrees had completed an ASHP-accredited hospital pharmacy residency compared with 53% and 46% of directors with postgraduate Pharm .D. and M.S. degrees, respectively. Of directors with M.B.A. or postgraduate Pharm .D. degrees, 73% and 77%, respectively, had less than 11 years of administrative experience; just over 50% of directors with M.S. and entry-level degrees had less than 11 years of administrative experience; just over 50% of directors with M.S. and entry-level degrees had less than 11 years of experience. The majority of directors with postgraduate degrees had been in their current position for five years or less. Additional research is needed to evaluate the relationship of these variables more fully.

Education, Pharmacy↗
PubMed1982

Reimbursement for nondistributive pharmaceutical services in hospitals.

The literature on reimbursement, especially by third-party payers, for clinical pharmacy services is reviewed. Allocation of total departmental expenses on a per-dose basis, subsidization of clinical pharmacy services through general pharmacy revenues, and inclusion of service charges with drug-product charges have been used successfully to support clinical services. Identification and documentation of benefits resulting from clinical pharmacy services is a vital element in the justification process; a new service has little chance for approval unless it documents cost savings. Published reports of clinical pharmacy services that obtained third-party reimbursement include programs in a cardiac-rehabilitation unit, patient education and monitoring, pharmacokinetics, and laboratory-results interpretation. Published guidelines for obtaining reimbursement for clinical pharmacy services are reviewed. An eight-point guide for obtaining reimbursement is recommended. It embodies: a commitment by the director of pharmacy, via departmental goals and objectives, to clinical services; presentation and acceptance by various key elements in a hospital's structure; accurate analysis of costs and benefits associated with the services; requests for reimbursement from third-party payers; continued analysis of the services' effects; and communication of experience with the services to the general public and the pharmacy profession. It is concluded that reimbursement by third-party payers is a step in the right direction and that clinical service charges should be separated from product charges. Further program development and research are needed.

Medical Records↗
PubMed1982

Therapeutic substitution practices in short-term hospitals.

Hospital policies concerning the automatic interchange of therapeutically equivalent drugs were examined. A questionnaire was sent to the chief pharmacists at 6326 shot-term hospitals throughout the United States. The survey items solicited demographic data and formulary policies on generic and therapeutic substitution. A total of 2437 (39%) usable questionnaires were returned. Approximately 40% of the hospitals reported that their formulary system allows the stocking of a single product to represent a given therapeutic category. A total of 751 hospitals reported that their formulary system allows automatic dispensing of the therapeutically equivalent drug product without contacting the physician for permission. Therapeutic substitution was found particularly prevalent in federally owned hospitals. There were regional variations in the existence of therapeutic substitution. Factors that appeared to be associated with therapeutic substitution were: drug use review activity, medical school affiliation, existence of a formulary system, perceptions of favorable view by the state board of pharmacy, and favorable perception of the savings generated through bid purchasing. Reasons for not engaging in therapeutic substitution included the following: (1) would not be accepted by the physicians, (2) interferes with physicians' right to select the drug, (3) unnecessary risk of civil liability, (4) violation of laws, and (5) expected benefits do not justify the cost. Most respondents thought that physicians are usually aware of therapeutic substitutions that occur. Although they were a minority, a large percent of the respondents had a formulary system that allowed automatic interchange of generically inequivalent products within a therapeutic class of drugs. The influence of therapeutic substitution on drug therapy outcomes and cost savings need to be evaluated.

Drug Prescriptions↗
PubMed1981

pH regulation in barnacle muscle fibers: dependence on extracellular sodium and bicarbonate.

Intracellular pH (pHi) regulation was studied in barnacle muscle fibers with pH-sensitive microelectrodes. The cells were acid loaded, and the subsequent recovery of pHi was monitored. The rate of recovery was reduced by one-third when external Na+ ([Na+]o) was replaced by Li+, but recovery was completely abolished when Na+ was replaced by choline or N-methyl-D-glucamine. In other experiments, varying amounts of Na+ were replaced by choline, and the acid extrusion rate, derived from the recovery rate of pHi, was calculated at a single value of pHi, 6.80. The dependence of the acid extrusion rate on [Na+]o could be described by Michaelis-Menten kinetics; at pHo (extracellular) = 8.0 and [HCO3-]o (extracellular) = 10 mM, the apparent Km and Vmax were 59 mM and 1.3 mmol x l(-1) x min-1. When [HCO3-]o was reduced to 2.5 mM at the same pHo, Km did not change significantly, but Vmax was substantially reduced. On the other hand, when pHo was reduced to 7.4 at constant [HCO3-]o, Vmax changed only slightly, but Km increased substantially. In similar experiments, we examined the dependence of the acid extrusion rate on [HCO3-]o. At pHo = 8.0 and [Na+]o = 440 mM, the apparent Km and Vmax were 4.1 mM and 2.1 mmol x 1-1 x min-1. When pHo was reduced to 7.4, Vmax was not altered, but Km substantially increased. The kinetic data are discussed in terms of the role of pHo, [Na+]o, and [HCO3-]o in the pHi-regulating system.

Acid-Base Equilibrium↗
PubMed1981

Influence of an experimental infection of nodular worms (Oesophagostomum spp.) on performance of pigs.

Four trials were conducted to determine the effect of different levels of nodular worm (Oesophagostomum spp.) infection on the performance of growing-finishing swine and on digestion and absorption of nutrients by the growing pig. In each of two growing-finishing trials, 48 crossbred pigs (average body weight 26.6 kg in trial 1 and 24.4 kg in trial 2) were individually housed and given a single infection of nodular worms (0, 550, 1,100 or 1,650 infective larvae/kg body weight in trial 1 and 0, 1,500, 3,000 or 4,500 infective larvae/kg body weight in trial 2). At 21 days postinfection, pigs given either 1,100 or 1,650 nodular worm larvae/kg body weight required more feed (P less than .05) per unit gain than pigs not infected, but for the 77-day test period, as a whole, nodular worms did not significantly affect performance. in trial 2, pigs given either 3,000 or 4,500 nodular worm larvae/kg body weight were lighter (P less than .05) and gained weight slower (P less than .05) for the first 21 days postinfection than pigs not infected, while pigs given 4,500 larvae gained slower (P less than .05) than pigs on the other three treatments. During the first 21 days after infection, pigs given 4,500 larvae/kg body weight consumed less feed (P less than .05 than pigs given either 0 or 1,500 larvae. Even at the higher levels of infection, nodular worms did not significantly affect performance over the entire 77-day test period. In each of the two other trials, eight crossbred barrows (average body weight 28.8 kg in trial 1 and 28.4 kg body weight in trials 2) were examined for the effects of two levels of nodular worm infection (0 and 4,950 larvae/kg body weight) on digestion and absorption of nutrients and on N balance. Pigs experimentally infected had a lower digestion coefficient for dry matter (P less than .01), ash (P less than .05), crude fiber (P less than .01), N free extract (P less than .05) and N (P less than .05) than noninfected pigs. Pigs not infected with nodular worms had a higher (P less than .05) N balance.

Animals↗
PubMed1981

Effects of forced exercise during gestation on farrowing and weaning performance of swine.

Forty-three gilts and 24 sows were tethered throughout gestation, and one-half were forced to walk on a treadmill 15 min daily 5 days a week. Exercised and nonexercised dams farrowed 10.0 and 10.2 pigs (P greater than .05) and weaned 8.1 and 7.9 (P greater than .05), respectively. Birth weight of pigs born alive from exercised and nonexercised dams averaged 1.6 and 1.5 kg (P greater than .05); weaning weights were 8.5 and 8.2 kg (P greater than .05), respectively. Sows farrowed 12% more pigs (P less than .05) than gilts and weaned 17% more pigs (P less than .05) that were 12% heavier at birth (P less than .01) than those of gilts. Forced exercise did not improve (P greater than .05) reproductive performance as measured by numbers of pigs farrowed and weaned or by birth and weaning weights. Mean length of gestation was not significantly affected by age of dam or exercise treatment. The interval between birth of first and birth of last pig per litter averaged 154 and 151 min (P greater than .05) for exercised gilts and sows, respectively, and 170 and 161 min (P greater than .05) for those not exercised.

Animals↗
PubMed1981

Efficacy of ivermectin against the swine kidney worm, Stephanurus dentatus.

Ivermectin in solution was given subcutaneously (in the neck) at the rate of 0.5 mg/kg of body weight to 5 sows naturally infected with kidney worm (Stephanurus dentatus). Six similar sows were used as nontreated controls. A total of 114 kidney worms were recovered from daily urine samples of 4 of the 5 treated sows (the 5th sow's samples were negative) during the first 4 days after treatment. Ten kidney worms were recovered from daily urine samples of 1 control sow on the 2nd and 3rd days of the post-treatment period. Examination of urine samples from treated sows for kidney worm eggs showed a precipitous numerical decrease. Treated animals became negative between the 5th and 12th days after treatment, and remained negative until necropsy on the 61st day. Compared with control sows, hatchability of eggs and survival of larvae from treated sows was reduced by 9% and 7%, respectively. Kidney worms were not recovered at necropsy from the treated sows, and a total of 392 kidney worms were recovered from the control sows (av 65).

Animals↗
PubMed1981

Efficacy of fenbendazole against the swine kidney worm Stephanurus dentatus.

Fenbendazole in ground feed was fed on 3 successive days at the rate of 3 mg/kg of body weight to 15 sows naturally infected with kidney worm (Stephanurus dentatus). Fifteen similar sows were used as nontreated controls. A total of 49 kidney worms were recovered from daily urine samples collected from 10 of the 15 treated sows within 5 days after the 3rd dose of treatment. One control sow passed 10 kidney worms on the 2nd and 3rd days. Urine samples from treated sows became negative for kidney worm eggs by the 5th to 12th posttreatment days, except for urine samples from 1 sow that contained a few eggs on the 12th day and another sow that contained a few eggs on the 19th and 33rd posttreatment days. Urine samples from control sows contained approximately the same number of kidney worm eggs in the posttreatment period as earlier. Compared with that in control sows, the hatchability of the parasite eggs from treated sows was greatly reduced. Kidney worms were not recovered at necropsy from the treated sows and a total of 860 kidney worms were recovered from the control sows (57 av).

Animals↗
PubMed1981

Pilferage of controlled substances in hospitals.

The incidence of pilferage of controlled substances and the systems of monitoring and surveillance of controlled substances in hospitals were studied. A questionnaire was mailed to a random samples of 285 pharmacy directors in short-term medical and surgical hospitals nationwide. Of the 162 respondents, 103 (64%) reported at least one documented or suspected case of pilferage in the past year. These 103 hospitals reported 352 separate incidence of controlled substances theft involving 11,285 dosage units. Drug diversion occurred in 76% of the hospitals with more than 100 beds and in only 28% of the hospitals with less than 100 beds. Nurses were implicated in 69% of the incidents; pharmacists and pharmacy technicians in 12%; housekeeping personnel in 4.7%; unit-ward clerks in 3.5%; and physicians in 2.4%. These incidents most frequency involved: meperidine, morphine, cocaine, oxycodone, hydromorphone, propoxyphene, pentazocine, diazepam, and codeine products. Larger hospitals, those with more frequent inventory audits, those that disperse controlled substances throughout their drug stock, and those that have more pharmacy personnel involved in the distribution of controlled substances all had a relatively higher incidence of pilferage. It was concluded that a substantial amount of pilferage of controlled substances occurs in hospitals and that more stringent methods of control and surveillance are needed.

Drug and Narcotic Control↗
PubMed1981

State regulatory positions concerning therapeutic substitutions in hospitals.

State regulatory agencies were surveyed to determine their views concerning hospital policies that allow therapeutic substitution. A questionnaire consisting of 10 close-ended questions was sent to the executive secretary of each board of pharmacy in the 50 states and District of Columbia. Agencies were contacted by telephone in four weeks if they did not respond. Of the 51 jurisdictions surveyed, 34 answered all of the questions, 13 answered some, and 4 did not respond. None of the 13 partial respondents expressed their views concerning the legality of therapeutic substitution in the institutional setting. Fifteen agencies indicated they would view this practice as illegal, 17 said it is in accordance with policies established by the P & T committee and therefore not subject to state or federal regulation, and two agencies gave qualified responses. Seven agencies indicated enforcement procedures would be initiated if they were to learn that therapeutic substitution was being practiced in a hospital within their jurisdiction. Three states were uncertain about what action would likely be taken, 23 indicated no action would be taken, and two gave qualified responses. All 39 agencies responding to the question indicated they had never taken action against the practice of a formulary system that allows therapeutic substitution. Few state laws address the practice of therapeutic substitution, and opinions of regulatory agencies vary. Moreover, the opinions rendered have not been tested in the courts.

Government Agencies↗
PubMed1981

Therapeutic substitution and the hospital formulary system.

Physicians consent and statutory regulations relating to therapeutic substitution are discussed. Some hospitals have adopted policies allowing the interchange of a chemically inequivalent product deemed therapeutically identical by the P & T committee. In the absence of statutory regulation, hospital pharmacists usually refer to (1) the physician's agreement to abide by hospital bylaws (including the formulary system) when joining the hospital staff, or (2) prescription blanks and order sheets preprinted with the statement "substitution permitted unless otherwise indicated" as the legal authority for therapeutic substitution. Only two states have addressed the legality of therapeutic substitution. An opinion of the Oregon Attorney General and a Washington state statute both authorize therapeutic substitution under certain circumstances if the prescriber has given prior consent. Neither of the states specifies, however, whether the agreement of prescribers to abide by hospital bylaws constitutes authorization of therapeutic substitution. It is proposed that state boards of pharmacy and state legislatures draft laws that address therapeutic substitution and specify acceptable methods of consent.

Formularies, Hospital as Topic↗
PubMed1980

Drug product selection: the Florida experience.

Drug product selection, the act of selecting and dispensing a lower cost generically equivalent product to that prescribed, is made possible in 46 states through recently enacted legislation. Florida's legislation is unique in that it requires pharmacists to product select under certain circumstances. This study reports on the results of a review of the Florida experience approximately one year after enactment of its drug product selection legislation. Nearly 132,000 prescriptions were sampled from 60 pharmacies during a four-month study period. This represents one per cent of all new prescriptions in the state and a three per cent sample of community pharmacies. Study results indicate that drug product selection on the average saves the consumer $1.92 per prescription. Further, under the provisions of this law the majority of cost savings (average reductions in acquisition costs between prescribed and dispensed products) are being passed along as savings to the consumer. During the four-month study period this amounted to a total prescription cost savings of nearly $425,000. Drug product selection occurs in approximately two per cent of all new prescriptions which compares favorably with results reported from other states but also suggests that additional savings can be realized under such legislation.

Cost Control↗
PubMed1980

Attitudes of pharmacists and physicians toward Florida's drug product selection law.

Pharmacist and physician attitudes were surveyed approximately 1 year after the implementation of Florida's drug product selection legislation. It was not possible to identify a consistent relationship between the attitudes of prescribers and pharmacists and subsequent drug product selection behavior, even though pharmacists were generally in favor of the law and physicians opposed it. However, neither saw the law as weakening their professional relationships. Both groups seemed to overestimate the degree of drug product selection activity actually occurring. From a methodological perspective, this suggests that a survey questionnaire approach to estimating these rates may not be valid.

Attitude of Health Personnel↗
PubMed1980

Potential and actual drug product selection rates in Florida.

A systematic review of new prescriptions conducted 1 year after the enactment of Florida's drug product selection law showed that 36.3% were potentially subject to product interchange. Product interchange actually occurred in only 6.2% of these potentially eligible prescriptions. Positive formularies established by the pharmacies reduced the eligible population to 8.1% of all new prescriptions and the product selection rate relative to these formularies was 14.7%. Twenty drugs accounted for nearly three-fourths of all drug product selection activity.

Drug Prescriptions↗